Stigma for Mental Illness High, Possibly Worsening

Despite widespread efforts to educate the public of the neurobiological basis for mental illness, researchers have found no improvement in discrimination toward people suffering with serious mental health or substance abuse problems.

This is according to a new study by Indiana University and Columbia University.

The findings raise concerns regarding the effectiveness of mental health awareness campaigns. Recently, advocates have embraced the message of “this disease is like any other,” and hoped this point would be driven home to finally reduce stigma toward mental illness in the United States.

“Prejudice and discrimination in the U.S. aren’t moving,” said IU sociologist Bernice Pescosolido.

“In fact, in some cases, it may be increasing. It’s time to stand back and rethink our approach.”

For many Americans suffering with mental illness, a fear of stigma often keeps them from seeking the medical help they need. When others find out, the sufferer can experience discrimination in employment, housing, medical care and social relationships, and this negatively affects the quality of life for these individuals and their loved ones.

The study, funded by the National Institute of Mental Health, examined whether American attitudes toward mental illness changed during a 10-year period — from 1996 to 2006 — a decade with numerous efforts focused on making Americans aware of the medical and genetic explanations for depression, schizophrenia and substance abuse.

The study analyzed public responses to survey questions throughout this particular decade as part of the General Social Survey (GSS), a biennial survey that includes face-to-face interviews. For the surveys, participants listened to a hypothetical scenario of a person with major depression, schizophrenia or alcohol dependency, and then answered a series of questions.

Even though Americans reported more acceptance of neurobiological explanations, this acceptance did nothing to change prejudice and discrimination, and in some cases, made it worse.

The study reveals that 67 percent of the public in 2006 attributed major depression to neurobiological causes, compared with 54 percent in 1996.

Also, a higher percentage of respondents were more supportive of professional treatment as the years went on, especially treatment from a psychiatrist, for treatment of alcohol dependence (79 percent in 2006 compared to 61 percent in 1996) and major depression (85 percent in 2006 compared to 75 percent in 1996).

However, the results show that although believing in neurobiological causes for these disorders increased support for professional treatment, it did nothing to alleviate stigma. The results show that, in fact, the effect increased community rejection of the person described in the vignettes.

Pescosolido said the study provides real data for the first time on whether the “landscape” is changing for people with mental illness. The negative results support recent talk by influential institutions, including the Carter Center, about how a new approach is needed for the fight against stigma.

“Often mental health advocates end up singing to the choir,” Pescosolido said. “We need to involve groups in each community to talk about these issues which affect nearly every family in American in some way. This is in everyone’s interest.”

The researchers suggest that stigma reduction efforts should focus on the person rather than on the disease, and should emphasize the abilities and competencies of people with mental health problems.

Pescosolido believes that civic groups, which are not usually involved in mental health issues, could be very effective in raising awareness on the needs for inclusion and dignity for persons with mental illness as well as their citizenship rights.

This study is published online in the American Journal of Psychiatry.

SOURCE: Indiana University

By Traci Pedersen

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